A 40-year-old female presents to your office with intermittent epigastric pain, which is worse after eating. She notices the pain is worse if she eats spicy or fatty foods. Over-the-counter antacids are not helping. Physical exam reveals a positive Murphy’s sign. She does have some nausea. Your most likely diagnosis is:

Harry Betts, an 85-year-old man, presents to your primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following will you include in your list of differential diagnoses?

A college student doing lawn work for his summer job, mowed over some poison ivy and is now presenting for a widespread, pruritic rash on bilateral upper and lower legs, bilateral forearms, and face.  He admits to wearing shorts and short sleeves while working. What would be the best treatment for him?

Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?  

A 25 y/o female who is 20 weeks pregnant, presents with new onset facial droop, facial pain and drooling.  Which diagnosis do you susupect?

*A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from:

A 23 y/o female comes to the urgent care with new onset facial pain.  She states “I don’t know where this came from.  I have never had this before!”  She describes the pain as a stabbing pain into her cheek and chin. She is an otherwise healthy female and is not taking any medications.  When you probe a little more, she said she was brushing her teeth when the pain started.  She applied ice to her face and it didn’t help.  Last routine dental visit was 5 months ago.  What diagnosis do you suspect?

Joan, a 35 year old female comes to see you for complaints of cold intolerance, fatigue, dry skin and weight gain. Her menstrual cycles have been heavy. Physical exam shows blood pressure of 138/80, pulse of 58 and palpation of the thyroid reveals an enlarged, firm gland. Her TSH is 76. Your best action is to:

When is referral to endocrinology indicated in a male patient diagnosed with gynecomastia?

In taking a history from a patient with depression, which is the most critical question for the NP to ask?